They did mention this as a possible need after it happened. It seems like sort of a last-resort procedure though. Do you know anyone who has need it?

Yes, several people. Recovery is a bit long and arduous but once everything is all healed the pain from the joint is gone (because the joint is gone). Functional limitations include difficulty walking on uneven terrain since you lost the side-to-side motion from the ST joint. I would try the footwear changes first.